DESCRIPTION: Tobacco use remains the most preventable cause of cancer and accounts for 30 percent of all cancer-related deaths. In addition, continued smoking after diagnosis of cancer is associated with greater morbidity, and increased risk of disease recurrence, second primary cancers and mortality -- although high rates of smoking cessation upon cancer diagnosis have been found, at least 30 percent of patients continue to smoke. Identifying factors associated with whether patients successfully quit or continue smoking following diagnosis would facilitate the development of smoking cessation interventions that are tailored to this unique, risk population. Cancer diagnosis poses a window of opportunity, or "teachable moment" for smoking cessation that is likely to raise perceived vulnerability to smoking-related health hazards and receptivity to physician advice. As such, smokers are likely to experience greater motivation, readiness and intention to quit smoking. On the other hand, smoking cessation in this context is hindered by the challenges associated with the stress of being diagnosed with a serious, life threatening disease. Newly diagnosed cancer patients typically report significantly elevated levels of psychological distress. Furthermore, initial abstinence often occurs under highly protected circumstances in which external factors such as hospital nonsmoking restrictions, pain, general anesthesia, and isolation from family and peers who smoke strongly deter smoking. To maintain smoking abstinence following hospitalization, patients must overcome these illness-specific barriers. The overall goal of this longitudinal study is to examine the prevalence, patterns and predictors of smoking cessation among patients recently diagnosed with tobacco-related cancers (lung, bladder, and head and neck cancer). The impact of the teachable moment as measured by cues to action, health beliefs, motivation, and cancer-specific psychological distress and the illness-context barriers of the presence of smokers in patients social network and global psychological distress on smoking cessation and maintenance will be examined. Eligible patients (N=300) will be assessed at three times; 1) baseline assessment (T1) will occur shortly after diagnosis, b) a follow-up assessment (T2) will occur 3 months post-diagnosis and c) a follow-up assessment (T3) will occur 12 months post-diagnosis. Patients will complete self-report questionnaires assessing tobacco use and key factors hypothesized to be related to post-diagnosis smoking status. Patients' self-reported tobacco use will be verified at follow-up via urinary cotinine assays.